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{{DISPLAYTITLE:Iliotibial band syndrome (ITBS) }} [[File:ITBS.png|right|thumb|300px|]]Iliotibial band syndrome (ITBS) generally causes pain in the outside of the knee, with the pain often arising after a couple of miles of running. The Iliotibial band (ITB) runs from the crest of the hip bone (Iliac) to the top of the shin bone (tibia) near the knee, hence the name. You can see the ITB in green in the picture belowITBS is a common issue for runners, with research suggesting it impacts about a 6^thof all runners<ref name="Noehren-2007"/>. Sometimes runners ITBS is confused with [[Knee Pain|pain under the kneecap]].  [[File:, but ITBSis normally specific to a small area on the outside of the knee, and is most noticeable when the knee is flexed to 30 degrees.jpg]]  There are a number of possible approaches to treating ITBS. ==Avoid Fuel Belts==Though , but even with the pain of numerous research studies into ITBS is felt near the knee, the origin quality of the ITBS information is at the hipremarkably limited<ref name="AderemLouw2015"/>. Therefore anything that presses on the ITB high on the leg, or worse the * '''The TFL can cause or aggravate ITBS. If you have been wearing a fuel belt, or any other type of belt around the hips, I'd recommend not wearing it until the ITBS has completely recovered. If you feel the fuel belt is worth it, try reintroducing it and see if the ITBS reoccurs''.  ==Massaging The Tensor Fasciae Latae==I have found the most effective treatment for ITBS is to focus on the Tensor Fasciae Latae (TFL), shown above in red. I use the [[Thumper]] to [[Massage]] the TFL, which can be quite painful, but I have found that works well, as massaging with my ITBS symptoms subside very rapidly after treatment. For a wonderful visualization of the TFL, check out http://www.getbodysmart.com/ap/muscularsystem/thighmuscles/anteriormuscles/tensorfasciaelatae/tutorial.html ==Foam Roller==Using the [[Foam Roller]] to [[Massage]] the ITB from the hip to the knee can help treat ITBSfingers. This can massage should be quite painful, so using your other leg to reduce combined with strengthening the pressure is often needed to keep things bearableTFL.  ==Strengthen the TFL== One of the best exercises for strengthening the TFL this is the 'Frankenstein march'. To do this you will need a stretch short resistance band like this <jfs id="B0000AJ057 " noreferb="true" n="resistance band with handles similar to [http:set"//www.amazon.com/SPRI-ES502R-Resistance-Attachment-Exercise/dp/B0000AJ057 this one]>. To do the exercise, stand on Put the band around your ankles and walk with your feet about shoulder width with apart, holding the handles so the band goes from your right hand to your left foot and vice versa. You need enough tension on the strap so that when you walk, you have to put a little an effort into keeping your feet apart. Walk a short distance, keeping your feet pointing straight ahead. Go far enough that you can feel the effort in your hips, but don't overdo it. * '''The Glutes'''. The TFL/ITB generally works together with your glutes, so if the glutes are weak, the TFL/ITB has to work harder. The hip abductors are your glutes (Gluteus Maximus, Gluteus Medius, & Gluteus Minimus), plus the TFL. The word "abduct" means to "lead away" and the hip abductors pull your legs outwards, away from your midline. Like the TFL, the Glutes need [[Massage]] and strengthened. The Frankenstein March also works to strengthen the Glutes. * '''Mobilize the ITB'''. [[Massage]] of the ITB from the hip to the knee can help mobilize the ITB. Using the [[Foam Roller]] to massage the outside of the thigh can be quite painful, so using your other leg to reduce the pressure is often needed to keep things bearable. You can also use your hand to massage the ITB and surrounding muscles (vastus lateralis and biceps femoris.)==* '''Ice=='''. Using [[Cryotherapy - Ice for Healing|Ice]] on the site of the pain can help reduce the swelling and pain, but it does not seem to help address the root cause. Using You can also ice is appropriate as part of a broader approach to treating ITBSthe TFL, which may be more effective.  ==Ibuprofen==* '''Avoid NDADs'''. [[NSAIDs and Running|NSAIDs]] like ibuprofen will help mask the pain and can reduce the inflammation of ITBS, but they can also retard the healing process<ref name="nsaid"/>. I would not recommend using Ibuprofen for ITBS. ==Worn * '''Replace Your Shoes=='''. It is possible for badly worn [[Shoes]] to change your biomechanics enough to trigger ITBS. It's worth checking your [[Shoes]] for excessive wear; not the tread on the outsole, but the midsole foam. Feel the thickness of the sole and see if it is significantly thinner in some sections, such as where the ball of the foot presses. ==* '''Biomechanics=='''. Poor biomechanics can cause ITBS, so having someone evaluate your [[Running Form]] may help. Another approach is to have someone video tape your running and check it for good form. You should check your [[Cadence]], as the correct Cadence can resolve many biomechanical issues like [[Overstriding]]. * '''Avoid Fuel Belts'''. Though the pain of ITBS is felt near the knee, the origin of the ITBS is at the hip. Therefore anything that presses on the ITB high on the leg, or worse the TFL, can cause or aggravate ITBS. If you have been wearing a fuel belt, or any other type of belt around the hips, I'd recommend not wearing it until the ITBS has completely recovered. If you feel the fuel belt is worth it, try reintroducing it and see if the ITBS reoccurs. * '''Foot angle'''. Personally, I've found that if my feet are turned even slightly outwards (AKA lateral rotation or duck feet) it can trigger ITBS quite rapidly. I suspect this is because this outward rotation causes the knee to tend to bend inwards and the muscles have to pull on the ITB to maintain stability. ==References==

<ref name="nsaidAderemLouw2015">Jodi Aderem, Quinette A. Louw, Biomechanical risk factors associated with iliotibial band syndrome in runners: a systematic review, BMC Musculoskeletal Disorders, volume 16, issue 1, 2015, ISSN [http://www.caringmedicalworldcat.org/issn/1471-2474 1471-2474], doi [http://dx.doi.org/10.1186/s12891-015-0808-7 10.1186/s12891-015-0808-7]</ref><ref name="Noehren-2007">B. Noehren, I. Davis, J. Hamill, ASB clinical biomechanics award winner 2006 prospective study of the biomechanical factors associated with iliotibial band syndrome.com, Clin Biomech (Bristol, Avon), volume 22, issue 9, pages 951-6, Nov 2007, doi [http://dx.doi.org/10.1016/sports_injuryj.clinbiomech.2007.07.001 10.1016/nsaidsj.asp SPORTS INJURIESclinbiomech.2007.07.001], NSAIDsPMID [http: Why We Do Not Recommend Them//www.ncbi.nlm.nih.gov/pubmed/17728030 17728030]</ref>